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Speak to any older person and they will tell you that from a physical point of view life does not get easier as we get older. In fact, things that we were once able to take for granted can become very difficult. If this process is allowed to continue unchecked, it is possible that we can get to a stage that we are no longer able to do the most basic of activities in order to care for ourselves, resulting in the loss of our independence.

The single most powerful thing we can do for ourselves in order to avoid this terrible situation is to undertake regular physical exercise, particularly in the form of specific functional strengthening exercises. Through such a program it is possible to minimize some of the negative physical effects of ageing, enabling us to maintain our independence and continue to lead a full, active and engaging life, in the comfort of our own home for as long as possible.

If you would like to know how specific strengthening exercises may be able to help you, give us a call on 95609393.

Back pain a common complaint throughout the general population, across all age groups, often related to issues such as poor posture or a lack of support when sitting down.

Typically, the severity of lower back problems can be assessed by looking for any signs or symptoms spreading down to the legs. Pin and needles, numbness, a burning sensation or a feeling of heaviness in the legs can be possible signs of nerve involvement.

Generally, inflammation is the first thing we need to manage. Heat pack or ice pack, rest, and anti-inflammatories are options to reduce pain. Gradually, with stretching exercises, flexibility and freedom of movement can be restored. However, long periods of time resting in bed is not good for muscle strength, length, or flexibility. Therefore, very specific exercises need to be commenced as soon as possible once the pain is settling down.

In terms of long-term management, core muscle strength is required to share the load of the upper body together with the back muscles. Moreover, stabilizers such as transverse abdominis (TA) and multifidus should be strengthened to increase the control of movement, and to decrease the risk of further episodes of back pain in the future. Evidence clearly shows us that core strengthening and general conditioning is the key to decreasing the risk of recurrent back pain.

Headaches can originate from many structures in the head, neck and upper back including joints, muscles and sinuses. Prolonged muscle tightness, stress-related tension, sinus pressure and poor posture are some of the most common causes of headaches.

Osteopathy treatment combined with self-management strategies, such as stretching, can often be one of the fastest remedies for relief of a headache. Gentle mobilisation of the spine and releasing of tight muscles around the back, neck and head can provide significant relief of headache symptoms. Osteopathic treatment may also help to improve circulation and removal of waste products that can often build up in areas of the body.

Adequate mineral intake can also enhance the effect of osteopathic treatment. Magnesium has benefits for headache sufferers as it can help to relieve muscular tension around the head and neck.

Many headache sufferers are among those who work at a desk in front of a computer. Sitting at a computer for prolonged periods can lead to poor posture and puts unhealthy pressure on the neck and upper back. These headaches are known as cervicogenic headaches.

Here are a few tips to avoid headaches at work:

1. Adjust your monitor height so that the top edge of your computer is at eye level. This will avoid excessive bending of your neck.

2. Be aware of the position of your shoulders while you are working on your computer to ensure that they are not slumped forward. Imagine that you have left the coat hanger in your t-shirt; this will cause a subtle widening of the collar bones and shoulders.

3. Position your key board at a distance which allows your elbows to be relaxed by your side and ideally at a 90 degree angle to the desk at which you are working. This will also allow your arms to be supported on the desk or arm rests of the chair and therefore eliminate the strain of your arms pulling on your shoulders and neck.

The typical answer to the commonly asked question is both. Excessive stress in the vicinity of a joint will always have an influence on surrounding musculature.

The consequence of untreated poor posture or repetitive strain injury accounts for more than 90% of patients that present to the clinic. Often these changes do not produce symptoms that are obvious to the patient until significant dysfunction has occurred. Untreated joint dysfunction leads to injury. Chiropractic serves to restore motion to restricted areas to reduce stiffness, pain and inflammation.

Hands-on therapy, dietary, ergonomic consideration and exercise prescription is provided to assist in maintaining the health of all patients. We treat all conditions including headache, neck and jaw related issues. Anything from head to toe.

As we age, joint stiffness starts playing an active role; whether due to old injuries, weakness in the joints, or simply because it isn’t easy growing older. However, that doesn’t necessarily mean that joint stiffness has to play an active role in your everyday life.

Knowing how to reduce joint stiffness will result in a higher quality of life – enabling you to do more on a frequent basis without having to worry about pain or difficult joints slowing you down. Thus, in order to gain your flexibility back, you may want to include the following joint stiffness remedies into your daily routine:

1.Apply hot/cold compress.

Reducing possible inflammation in the joints is key to decreasing stiffness, thus, either a cold or hot compress could work. Apply a cold ice pad to stiff joints for 15-20 minutes or a heat pad to muscles in order to help your muscles relax and increase circulation. Alternatively, you can always take a steamy shower in order to add heat to the muscles and stiff joints – helping you to relax simultaneously as well as easing the possible joint pain.

2.Regular exercise.

Exercise, in any form, is always beneficial to your health. Not only do you improve muscle strength and growth, you’re also loosening up stiff joints. However, it’s important to train with a professional who knows exactly which exercises would be beneficial and which ones could possibly harm you more than you may think.

Remember, unnecessary weight also adds to your problem, which is why exercise should definitely play a role in your daily activities – even if it’s only for 30-minutes per day.

3.Physiotherapy.

Physiotherapy for joint stiffness works wonders in helping your joints and muscles recover. By using clinically tested practices such as massage, mobilisation and clinical Pilates, joint stiffness can become a thing of the past. “We also supplement our treatments with corrective exercise prescription, postural exercise and ergonomic advice, to ensure not only short-term relief from pain but prevention in the longer term.”

Contact us to schedule your physiotherapy session in order to reduce joint stiffness.

4.Consume a healthy diet.

Mostly due to inflammation, joint stiffness needs to be tackled first and foremost by the foods you choose to consume. Ginger is an excellent anti-inflammatory which can be consumed on a daily basis, along with cherries and grapes. According to Christopher D. Black, Ph.D., assistant professor of kinesiology at Georgia College and State University in Milledgeville, GA, “It relieves symptoms by blocking an enzyme that’s a key component of the inflammatory process.”

5.Acupuncture.

Although not a favourite for everyone, acupuncture has been proven to reduce swelling and stiffness in the joints of those suffering from osteoarthritis of the knee. In a German study, 15 sessions of acupuncture, along with conventional joint stiffness treatments resulted in more flexibility and mobility than conventional joint stiffness treatments alone. It may not be everyone’s first choice, but acupuncture may be the missing piece to your treatment puzzle.

Incorporating joint stiffness treatment into your daily life could drastically improve your mobility and quality of life – ensuring that you’re able to enjoy the small things in life without having to make drastic changes.

Regardless of why you have joint stiffness in the first place, consuming a healthy diet and adding the above-mentioned joint stiffness remedies will surely help to add a little bit of flexibility to everyday activities.

Many people use the term Chronic to convey just how excruciating a pain is. However, what the term really means is simply that the pain has been there for longer than three months, even if it’s not very bad. The distinction is made after three months because most injuries to tissues, either muscle, bone or joint, has had a chance to heal and resolve by this time.

Why make the distinction?

The difference between pain that has just happened and pain that has been there for a long time has implications for treatment. Chronic pain requires different management and is likely to be caused by more than one thing where as short-term pain (also known as acute pain) often has a distinct cause, such as a fall.

What are some examples of acute conditions?

A sprained ankle, torn muscle, a bruise and even a broken bone are all examples of injuries that occur suddenly and usually follow a typical pattern of healing. They usually go through an inflammatory reaction with the area being red, hot, swollen and painful to touch. This period usually lasts for a few days and is a normal part of the healing process as the body works to remove damaged tissue and repair the affected area. Different tissue types take varying amounts of time to heal. The severity of the injury will also affect healing times. Some acute injuries can become chronic if something goes wrong in the healing process. Some acute injuries are so bad they won’t heal without medical care. For example, fractures need to be kept as still as possible to allow the broken bones to heal together in the correct position.

Some pain and illnesses develop over time and are chronic in nature, usually starting insidiously and becoming progressively worse. Osteoarthritis, multiple sclerosis and rheumatoid arthritis are all examples of chronic conditions that can cause chronic pain.

For some people, even though their injury has healed and no significant cause can be found, pain persists. This type of pain can be particularly distressing and requires a holistic approach to treatment, particularly addressing the emotional costs that come with suffering from long-term pain.

Certain factors will predispose someone to developing this type of pain including recent or past emotional trauma, anxiety and depression. Unfortunately chronic pain often causes people to adopt a vicious cycle of rest, which causes more stiffness and pain, which then leads to more pain and so on.

Your physiotherapist is well trained to help you cope with chronic pain and get you back to a more functional level and doing the things you love.

Chronic Pain Project

Sometimes the internet can be a confusing place, full of misinformation, particularly from people trying to sell you things. A recent website developed by the Department of Health in Western Australia aims to provide evidence-based support and education to pain sufferers.

Have a look here at painhealth.csse.uwa.edu.au

Rotator Cuff Tears

WHAT IS THE ROTATOR CUFF?

The rotator cuff refers to four small muscles in the shoulder joint that connect the shoulder blade to the upper arm. They stabilize the shoulder joint, and also act to rotate the shoulder inwards and outwards. The muscles attach at different points around the shoulder blade and attach as four tendons into the top of the humerus (upper arm bone).

HOW DO THEY TEAR?

These tendons are commonly injured through a fall onto an outstretched arm. However, they can tear from seemingly harmless movements of the arm repeated over a long period of time if the tendons are weakened. This is often referred to as ‘repeated microtrauma’. Tears occur most commonly at the point where the muscle turns into tendon, called the musculotendinous junction.

WHAT DOES IT MEAN IF I TEAR MY ROTATOR CUFF?

What to expect after a rotator cuff tear depends on how bad the tear is. It is possible to tear the tendon completely in two, which usually requires a surgical repair and subsequent rehabilitation. Partial tears can heal with rehabilitation and the length of time required will depend on the severity of the tear. Unfortunately, while many rotator cuff tears are resolving and healing, secondary complications begin to occur. The shoulder girdle is a very complex and flexible part of the body and as such is quite vulnerable to pain caused by poor movement patterns Many people move differently when they have pain. They might tend to elevate the shoulder blade, move their neck less to that side or simply move that arm less.

A common condition associated with rotator cuff tears is shoulder impingement, which is where, due to poor muscle control, structures within the shoulder joint are compressed and irritated as the arm is moved.

CAN PHYSIOTHERAPY HELP?

Physiotherapy is an important part of the rehabilitation process of rotator cuff tears, those both surgically and naturally repaired. Your physiotherapist will help to prevent secondary neck and shoulder problems and give you a strengthening program to restore you to your previous function. For the best outcomes it’s important to seek treatment as soon as possible and get started on your rehabilitation program.

A stress fracture is a microscopic fracture of the bone that is so small that it often cannot be picked up on X-ray. If left untreated, a stress fracture can cause significant disability and develop into a full fracture, possibly even requiring surgery.

The majority of stress fractures occur in the lower limb, being particularly common in the hip, shins and foot at points where the most force passes through when weight bearing. Most stress fractures are overuse injuries and are common in long distance runners.

What are the symptoms?

As with many overuse injuries, the pain of a stress fracture starts gradually, beginning with pain during or after activity or sometimes the morning after. If activity continues without modification, the pain will gradually increase. Eventually most people are unable to maintain their usual activity level. Stress fractures are very common in runners and in military personnel who are required to march for long periods. A stress fracture will be more likely to occur in a person who has weaker bone strength, such as someone with osteoporosis, which is itself affected by many factors such as calcium intake, vitamin D deficiency and a history of inactivity.

How are stress fractures treated and how long will it take to get better?

Stress fractures can easily be mistaken for other conditions such as shin splints. As the fracture is often too small to show up on X-ray, definitive diagnosis can be made using MRI or bone scan.

After diagnosis, the most important part of treatment will be resting the area to allow the bone to heal before resuming activity. Stress fractures usually need at least 6 weeks to recover fully. Some areas of the body have poor blood supply, which makes healing more complicated. For example, stress fractures of the navicular bone of the foot may need to be kept still and placed in a boot or cast for a period of time to heal properly. Other aspects of treatment will involve correcting any factors that contributed to the original injury. There is some evidence that unsupportive footwear is a risk factor, along with poor biomechanics and weak muscles that provide inadequate support to the skeletal system during activity. Speak to your physiotherapist if you suspect you may have a stress fracture or simply want to know more.

Healthy Lifestyle Changes To Make This New Year

Most of us start the New Year with some ideas of how we will change our lives for the better. Here are some tips for a better lifestyle and healthier outlook for the coming year.

Be proactive about your health.

Take time to listen to the advice of health care professionals and seek treatment for niggling issues before they become bigger.

Aim to be a little bit more active every week.

You can include any kind of activity, just try to move a little bit more each week. There is nothing more disheartening than starting a new hobby and increasing your program too quickly only to develop an injury that sets you back. Pace yourself with the view of realistically maintaining your new activity.

Take the advice of health professionals.

Physiotherapists know only too well that their advice is not always taken seriously. Unfortunately, some conditions do take hard work and time to resolve. Quick fixes only exist for relatively few conditions and the reality is that problems that develop over a few months don’t resolve overnight. Follow your physio’s advice for the best outcome. (And remember to do your home exercise program!)

Use exercise as a way to improve social and mental wellbeing.

While any amount of exercise will have a positive effect on your mental health, you can use a new hobby to expand your social circle and even improve self-esteem as you find yourself mastering a new skill. Try something a little different!

Pay attention to your diet.

While dietary fads are questionable in their effectiveness, there is no harm in monitoring what you are eating just a little more closely in the New Year. Remember to balance your meals with enough carbohydrates, protein, vitamins and minerals.

Swap sugary drinks for water.

Adequate hydration is an important part of keeping your body functioning well. Sugary drinks can also add a deceptive amount of calories to your daily intake.

None of the information in this newsletter is a replacement for proper medical advice. Always see a medical professional for advice on your individual injury.

Most of us are familiar with the post-exercise soreness that comes after a particularly strenuous exercise session. This pain, which is usually accompanied by stiffness and weakness, is often referred to as Delayed Onset Muscle Soreness, abbreviated to DOMS.

It is unclear exactly what the purpose of this pain is, as it is maximal approximately 24-48 hours following an intense exercise session. However, we do know that muscles experiencing DOMS show signs of micro-tears throughout the tissues and the effects are worse following eccentric (lengthening under tension) exercises more than other types.

While DOMS is not indicative of any serious injury and has no lasting side effects, it can be very uncomfortable and is problematic for anyone who needs to perform again quickly, such as an athlete in a tournament stretching over a few days.

A person suffering from DOMS may also be at a higher risk of injury if they continue to play sport at their usual level. Understandably, many people are interested in how to avoid or reduce the effects of DOMS.

There is plenty of anecdotal evidence on how to reduce DOMS, however high-quality research is limited and there is certainly no quick fix to this problem.

When it comes to avoiding DOMS, both a warm up before exercise and a cool down afterwards are important. Many experts also recommend using a foam roller on affected muscles following exercise. And while many people, particularly long-distance athletes are fond of using anti-inflammatory medication to reduce pain after exercise, the evidence shows that its effectiveness is limited and perhaps not worth the side effects of using the medication regularly.

Other advice includes gentle exercise, such as 20 minutes on a stationary bike, and mild stretching. Staying hydrated during sports is always important, and keeping your fluid intake adequate while experiencing soreness afterwards can also help. If you are particularly brave, ice baths have recently been shown to have mild benefits in pain reduction.

Shoulder Dislocations

The shoulder is an amazing joint with incredible flexibility. It doesn’t attach directly to the spine, like the hip joint; instead, it is held to the body through a

complicated system of musculature and indirectly by the collarbone (clavicle) to the front of the rib cage. Many other joints in the body are extremely stable, thanks to the structure of the bones and ligaments surrounding them. However, the shoulder has so much movement that some stability is sacrificed. It is for this reason that shoulder dislocations are a relatively common occurrence.

What is a dislocation and how does it happen?

As the name suggests, a dislocated shoulder is where the head of the upper arm is moved out of its normal anatomical position to sit outside of the shoulder socket joint. Some people have more flexible joints than others and will unfortunately have joints that slip out of position more easily and without much cause. Other people might never have a dislocated shoulder except for a traumatic injury that suddenly forces it out of position. The shoulder can dislocate in many different directions, the most common being anterior. This occurs when the arm is raised and forced backwards in a ‘stop sign’ position, which can occur in many situations.

What to do if this happens

The first time a shoulder dislocates is usually the most serious. If the shoulder doesn’t just go back in by itself (spontaneous relocation), then a professional will need to to put it back in. This needs to be done by a professional as they must be able to assess what type of dislocation has occurred, and often an X-ray needs to be taken before the relocation happens.

A small fracture can actually occur as the shoulder is being put into place, which is why it is so important to have a professional perform the procedure.

How can physiotherapy help?

Following dislocation, your physiotherapist can advise on how to allow the best healing for the shoulder. It is important to keep the shoulder protected for a period to allow any damaged structures to heal as completely as they possibly can. After this, a muscle-strengthening and stabilization program can begin. This is aimed at strengthening the muscles around the shoulder to provide further stability and prevent future dislocations.

The information in this newsletter is not a replacement for proper medical advice. Always see a professional for assessment of your individual condition.

Started a new exercise regime lately and noticed your balance isn’t quite up to scratch? Chances are, you need to dial things back a little and return to the basics. Balance is an important part of fitness and improving your balance can dramatically improve your performance.

What is balance?

Balance is a state in which weight is evenly distributed in order to prevent falling. Balance has major parts:

Sight

Vestibular system (the inner ear)

Proprioception

Change any one of these three variables and you’ll challenge your balance in different ways.

What is proprioception?

Proprioception refers to the awareness of a person about their body’s position in space. The origin of the word is derived from Latin, and it translates as “one’s own perception”. The central nervous system gains sensory input from receptors in the skin known as mechanoreceptors. This information is processed by the brain, and helps to translate data sent from the body in the form of vibrations, pressure, motion and joint position. Proprioception helps to maintain stability.

How can I test and improve my proprioception?

Stand with two feet together.

Close your eyes.

Count how long you can maintain your balance for.

Try again, this time standing on one foot. Close your eyes only once you have found a steady posture with your eyes open.

To increase difficulty, stand on an uneven surface, like a pillow on the floor. Start by standing with two feet together; stand on one foot if this becomes too easy.

While this isn’t a definitive test, if there is a significant difference in your balance when your eyes are open to when your eyes are close, or from the right side to the left side, your proprioception might be a little diminished.

Speak to your therapist for more practical tips on how to reduce injury incidence by improving your balance and proprioception.

Meniscal Tears:

The knees take a lot of impact when doing medium- or high-impact activities such as running, jumping, hill-walking and playing field sports. The meniscus is commonly damaged during these activities, and can be a cause of significant pain and movement dysfunction if damaged. What exactly is this mysterious meniscus, and why is it so important?

What is the role of the meniscus?

The meniscus is a thin, fibrous cartilage lining the bones of the knee. Its main function is to absorb shock when performing weight-bearing activities such as walking, running or hopping.

The meniscus in the knee is c-shaped, and there is one on the outside (lateral) and one on the inside (medial) of the knee joint. The medial meniscus is more commonly damaged than the lateral meniscus, because of the fact that more weight is transferred through the medial knee joint in normal movement.

What causes meniscal damage?

Twisting forces most frequently damage the meniscus. For example, if a soccer player’s foot is planted on the ground and their body rotates around the knee, the meniscus will often be unable to withstand the pressure and will sustain a strain or a tear. This can be of varying degrees, to a few stretched fibres right up to a large tear involving multiple areas of the cartilage. A locking, clicking or clunking may be felt in the knee upon movement. Your therapist will be able to perform clinical tests to check whether the meniscus is likely to have been damaged or not.

Can I recover from a meniscal injury?

Depending on the extent and location of the injury, many patients have excellent functional outcomes with physiotherapy management. This typically involves strengthening the muscles around the knee as well as increasing the range and training task-specific activities. Sometimes, a referral to an orthopaedic specialist may be necessary to determine whether or not surgery may be appropriate. If you have any doubts, talk to your physiotherapist about your options.

None of the information in this newsletter is a replacement for individual advice. Always see a professional for advice on your individual injury.

If you’ve just taken up running, you probably think that getting started is simple – you just run as far as you can and then run further the next time. Like most things, the reality is a little more complicated. Here are some tips to make the most of your running program and avoid injury.

• Don’t overdo it.

Rest is actually a big part of a training program. Your body needs time to recover and rebuild muscle. Not giving yourself adequate time to rest leads to greater risk of injury and you won’t improve as quickly as you might think. Aim to run three times a week.

• Don’t forget strength training.

Even if you’re trying to improve endurance, surprisingly, increasing strength can make a big difference. Particularly if you focus on specific muscles that may be weaker on one side of the body. This is also an important part of injury prevention. Your physiotherapists can help you to identify any weak muscles and develop a strengthening program.

• Your shoes and running surface matter.

Running on hard or uneven surfaces leads to a greater risk of injury than running on grass, which allows for a more natural distribution of forces through your foot. Having shoes that fit your foot properly and also provide necessary support is an essential part of your injury prevention plan.

• Listen to your body.

As you improve and push your abilities forward there will be many aches and pains. Most will only last for a day or two and DOMS (delayed onset muscle soreness) is a normal if not annoying part of getting stronger. However, if pain feels more serious, lasts for more than 48 hours or is preventing you from running speak to a professional as soon as possible. Running injuries do happen and can take a while to resolve. Early treatment is the best option for good outcomes. Speak to your therapist for more practical tips on how to improve your running and prevent injuries.

Common Running Injuries

Running is a great way to stay in shape, manage stress and increase your overall wellbeing, however it’s not without it’s drawbacks. While being a low risk activity, there are a few injuries that commonly affect runners. As running is a repetitive impact activity, most running injuries develop slowly and can be difficult to treat. Here are three of the most common conditions faced by runners.

1. Runner’s Knee:

Runners knee is a persistent pain on the inside of the knee caused by the dysfunctional movement of the kneecap during movement. The kneecap ideally sits in the centre of the knee and glides smoothly up and down as the knee bends and straightens, in a process described as tracking. If something causes the kneecap to track abnormally, the surface underneath can become worn, irritated and painful. The pain might be small to start with, however left untreated, runner’s knee can make running too painful to continue.

2. Shin Splints:

Shin splints is a common condition characterised by a recurring pain at the inside of the shin. While the cause of this condition is not always clear, it is usually due to repeated stress where the calf muscles attach to the tibia (shin bone). Why this becomes painful is likely due to a combination of factors that can be identified by your physiotherapist to help you get back on track as soon as possible.

3. Achilles Tendonitis:

The Achilles tendon is the thick tendon at the back of the ankle that attaches to the calf muscles. The amount of force that this tendon can absorb is impressive and is vital in providing the propulsive force needed for running. If the stresses placed on the tendon exceed its strength, the tendon begins to breakdown and become painful.

None of the information in this newsletter is a replacement for proper medical advice. See one of our professionals for advice on your individual injury.